Partners towards autonomy: risky choices and relational autonomy in rehabilitation care
Bibliographic record
Abstract
PURPOSE: A common source of ethical challenge for health care professionals (HCPs) in rehabilitation is situations when patients wish to make risky choices not related or contrary to rehabilitation goals. We explore the potential contribution of a relational understanding of autonomy for orienting clinical practice when patients wish to enact choices with associated risks for the patient or others. METHOD: We provide a theoretical analysis that is oriented by an examination of risk and a relational conception of autonomy, as relevant to rehabilitation care. We illustrate our analysis through the examination of a clinical case. RESULTS: Relational autonomy assumes that the patient, and the patient's decisional autonomy, is situated and shaped by relationships. From this perspective, HCPs can engage in a process of communication and deliberation with the patient about the risky choices at issue, leading towards improved patient autonomy. CONCLUSIONS: Relational autonomy can contribute to understanding patients' risky choices and guiding HCPs as they partner with patients towards autonomy. Such an approach supports patient-centred rehabilitation care. Ultimately, as clinicians respond to a patient who wishes to enact a risky choice, they should aim for a partnership towards autonomy with the patient and family.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".